Why Does Your Heel Hurt Even When You Haven’t Injured It?
You wake up one morning and your heel hurts.
You cannot remember twisting it, falling, hitting it or doing anything unusual.
Maybe you have been walking normally. Perhaps you have not even changed your exercise routine.
So why is your heel suddenly sore?
Heel pain does not always come from one obvious injury. It can develop gradually when the tissues around the heel are exposed to more load than they are currently accustomed to, or when other factors influence how your foot and lower limb are working.
Sometimes the change is obvious.
You start running again.
You spend a weekend walking around a new city.
You begin a job that keeps you standing all day.
Other times, the change is much smaller and harder to notice.
The important point is that unexplained heel pain is worth paying attention to, particularly if it persists or starts affecting the way you walk.
Your heel takes a lot of load every day:
Every time you take a step, your feet have to deal with your body weight and the forces created as you move.
Walking to the kitchen might not seem like much.
But multiply that by thousands of steps across a normal day.
Then add stairs, commuting, exercise, standing at work, shopping and weekend activities.
Your heel is exposed to a considerable amount of repetitive loading.
That does not mean walking is damaging your feet.
Your body is designed to tolerate load.
Problems can arise when the amount or type of load changes faster than your body can comfortably adapt.
Why can heel pain appear gradually?
Imagine you normally walk 5,000 steps a day.
You start a new job where you are standing and walking for most of an eight-hour shift.
You have not injured your foot.
But your daily workload has changed dramatically.
Your heel may start feeling sore after several days or weeks.
This is one reason people are sometimes surprised by heel pain.
There may not be a single moment when anything “went wrong”.
Instead, symptoms can develop gradually as the cumulative demand on the area changes.
Could it be plantar fasciitis?
One common cause of pain around the underside of the heel is plantar fasciitis.
The plantar fascia is a strong band of connective tissue that runs along the bottom of the foot and helps support the foot as you move.
When this area becomes painful, people often describe discomfort around the heel or arch.
A classic pattern is pain that is particularly noticeable with the first few steps after getting out of bed or after sitting for a long period.
However, not every case of heel pain is plantar fasciitis.
Heel pain can have several possible causes, and symptoms can overlap.
This is why a persistent sore heel should not automatically be labelled as plantar fasciitis based on location alone.
Why does my heel hurt when I take my first steps in the morning?
Morning heel pain is one of the clues commonly associated with plantar fasciitis.
You have been lying still for several hours.
Then you stand up and put your full body weight through the foot.
Those first few steps can feel surprisingly painful.
Some people find the discomfort eases after they walk around for a while, although it may return later after prolonged standing or activity.
This pattern can be useful information when discussing your symptoms with a healthcare professional.
It does not, by itself, confirm a particular diagnosis.
Could standing all day be causing your heel pain?
It can contribute for some people.
Jobs that involve prolonged standing can place a large amount of repetitive load through the feet.
Retail workers, hospitality staff, healthcare workers, teachers, tradespeople and others may spend much of the day on their feet.
If your heel pain appeared after starting a new role, increasing your hours or changing your work environment, the timing may be significant.
Hard floors may also make prolonged standing less comfortable for some people.
Again, the issue is not necessarily that standing is “bad”.
It may be that your current workload exceeds what your body has recently been accustomed to.
When should heel pain be checked?
Heel pain that is mild and improving may settle with appropriate changes to activity.
However, consider getting it assessed if:
- the pain persists for several weeks
- symptoms are getting worse
- you are changing the way you walk
- you cannot comfortably exercise
- the pain is interfering with work or everyday activities
- you have significant morning pain that continues
- you develop swelling, numbness or weakness
- the pain began after a change in activity and is not settling
An assessment can help determine what structures may be involved and whether factors such as activity, footwear, strength or lower-limb movement could be contributing.
When is heel pain more urgent?
Not all heel pain should be treated as a routine musculoskeletal problem.
Seek prompt medical assessment if you develop severe pain following significant trauma, cannot put weight through your foot, have significant swelling or deformity, or develop concerning symptoms such as marked redness, warmth or fever.
If you have a medical condition that affects circulation, sensation or your ability to heal, persistent foot pain may also warrant earlier assessment.
Can a chiropractor help with heel pain?
Depending on the cause of your symptoms, chiropractic care may be appropriate for some types of musculoskeletal heel and foot pain.
An assessment may consider your foot and ankle movement, lower-limb strength, walking pattern, activity levels, footwear, previous injuries and the demands you place on your feet.
Management may include appropriate exercises, activity modifications, movement advice or hands-on care, depending on your individual presentation.
If your symptoms indicate that another healthcare professional should assess the problem, referral may be recommended.
FAQ
Why does my heel hurt if I haven’t injured it?
Heel pain can develop gradually from changes in activity, prolonged standing, footwear, exercise or other factors affecting how the foot and lower limb handle load. An obvious injury is not always involved.
Is heel pain without an injury plantar fasciitis?
It can be, but not always. Plantar fasciitis is one common cause of heel pain, but other conditions can produce similar symptoms. An assessment may help distinguish between them.
Why does my heel hurt when I first get out of bed?
Pain with the first steps in the morning is a common feature of plantar fasciitis. However, morning heel pain does not by itself confirm the diagnosis.
Should I keep walking if my heel hurts?
It depends on your symptoms. Gentle activity may be appropriate for some people, while repeatedly doing activities that significantly increase pain may not be helpful. Consider reducing aggravating activity and getting advice if symptoms persist.
Can bad shoes cause heel pain?
Footwear can influence comfort and the way your feet handle activity, particularly if you have recently changed shoes or are using worn footwear. However, heel pain usually has more than one potential contributor.
When should I see someone about heel pain?
Consider an assessment if heel pain persists, worsens, changes your walking pattern or interferes with work, exercise or everyday activities. Severe pain after an injury, inability to bear weight or significant swelling should be assessed promptly.
If your heel keeps hurting despite having no obvious injury, an assessment may help identify what is contributing to the problem. Wellbeing Chiropractic has clinics across Melbourne, Sydney and Brisbane. Book an appointment to discuss your symptoms and have your foot and lower-limb movement assessed based on your individual history and examination findings.
